Democracy Gone Astray

Democracy, being a human construct, needs to be thought of as directionality rather than an object. As such, to understand it requires not so much a description of existing structures and/or other related phenomena but a declaration of intentionality.
This blog aims at creating labeled lists of published infringements of such intentionality, of points in time where democracy strays from its intended directionality. In addition to outright infringements, this blog also collects important contemporary information and/or discussions that impact our socio-political landscape.

All the posts here were published in the electronic media – main-stream as well as fringe, and maintain links to the original texts.

[NOTE: Due to changes I haven't caught on time in the blogging software, all of the 'Original Article' links were nullified between September 11, 2012 and December 11, 2012. My apologies.]

Sunday, January 15, 2012

The time for private health care has arrived

As a physician who has worked in the public health-care system for more than 30 years, I have seen many positives in health-care delivery, such as primary care networks and electronic medical records.

At the same time, I have been dismayed to see that access has deteriorated for many patients seeking care with my colleagues and me. Our health-care system, mandated by the Canada Health Act to have public administration, has become bloated and inefficient.

Our health outcomes in Canada underperform compared with our 34 peers in the Organization for Economic Co-operation and Development, given the fact we are spending at the sixth highest level per capita and as a percentage of GDP. In its latest OECD health report released in November 2011, Canada was second lowest in the number of acute care beds per 1,000 population, the second highest occupancy of those fewer beds, and the longest wait from referral to specialist consultation.

More recently, it has been alarming to see many new specialist MD graduates across Canada having difficulty finding jobs in spite of overwhelming demand from family physicians seeking timely access to specialists for their patients.

In Canada, governments have spent hundreds of millions of dollars on increasing the number of doctors being trained as witnessed by the change from 1,700 trainees in 2005 to just over 3,000 this year, of which 1,800 will train as specialists. We are finally going to have enough family physicians and specialists to make a real difference in access to medical care.

Unfortunately, most specialists need acute care beds and some need procedure or operating rooms; yet, Canada has had very little real growth in this infrastructure over the past decade. In Alberta, politicians cut ribbons opening new facilities while closing beds and operating rooms at existing sites. We desperately need net growth in these resources and the operational budgets to run them, or the number of unemployed specialists will explode along with waiting lists as the baby boomers peak.

Canada, Cuba and North Korea remain the only countries in the world to make private funding for medically necessary services essentially illegal. We are in the ludicrous situation in which some provinces turn a blind eye to enforcing the Canada Health Act and others, including Alberta, remain rigid. This has created an even more ridiculous scenario where surgeons and their patients from Ontario and Alberta fly to Vancouver to do surgery in a private facility because access to elective surgical care in their home province is so poor.

It was said during the recent Alberta PC leadership campaign that the time has come for Canadians to have a mature adult discussion on allowing some element of private health care for scheduled services.
The private sector could make a difference very quickly and could be funded privately or by government, as occurred during the very successful Calgary Health Resource Centre experiment that provided faster access, cheaper costs and, in the view of the vast majority of their almost 5,000 hip and knee replacement patients, outstanding care.

A dilemma exists: Government funding is finite, our health-care system is struggling, we have high patient demand, doctors available and a lack of resources to solve the issues. What we have been doing in health care for 30 years is clearly not working, so, hopefully, Canadians will consider all options to reform our health system for the better.

Robert Hollinshead is a Calgary Orthopedic surgeon and past president of the Alberta Medical Association.

Original Article
Source: Calgary Herald 

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